خطورة حدوث القصور الكلوي الحاد عند المرضى المقبولين في المشفى بسبب انكسار معاوضة قصور قلب احتقاني
Abstract
شملت الدراسة (96) مريضا مقبولين في المشفى بتشخيص رئيسي قصور قلب احتقاني(CHF )، عرّف القصور الكلوي الحاد(ARF) على أنه الارتفاع بقيم كرياتينين المصل أكبر أو يساوي (0,5) ملغ/دل بالمقارنة مع قيم كرياتينين المصل عند القبول. كما درست مجموعة من العناصر على أنها منبئات مستقبلية بتطور (ARF).
كان متوسط قيمة كرياتينين المصل عند القبول (1,71±1,15) ملغ/دل، مع متوسط لتصفية كرياتينين المصل
(57,2) مل/د. تطوّر (ARF) عند 31 مريضاً (32,29%)، ذروة الإرتفاع تراوحت بين
(0,5-3,83) ملغ/دل.
تطوّرت معظم الحالات بين اليومين الرابع والسادس من القبول عند 26 مريضا ( 83,87%). ترافق ARF مع زيادة في نسبة الإمراضية والوفيات، وطول فترة البقاء في المشفى. تضمنت عوامل الخطورة: انخفاض قيمة صوديوم المصل عند القبول، ارتفاع قيمة كرياتينين المصل عند القبول، استعمال مثبطات الأنزيم القالب/مثبطات مستقبلات الأنجيوتنسين، سوء الوظيفة الإنبساطية المحسوبة باستخدام الإيكو القلبي .
This is an observational study based on hospital medical records of (96) patients admitted with a principal diagnosis of CHF. ARF is defined as an increase in serum creatinine of 0.5mg/dl compared to the admission value.Multiple elements are studied as possible indicators of ARF development. Mean serum creatinine is 1.71±1.15mg/dl, and calculated creatinine clearance is 57.2 ml/min. ARF has developed in 31 patients (32,29%), with a peak increase in serum creatinine by (0.5-3.83) mg/dl. An increase in serum creatinine is observed in (83.87%) of patients on days (4-6) of admission. ARF is associated with increased in-hospital mortality, morbidity, and prolongation of hospital stay. Risk factors for ARF include: increase serum creatinine on admission, hyponatremia, ACEI/ARB therapy, and diastolic dysfunction.
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